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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Motivators and barriers for paediatricians discharging patients

Erin Turbitt A B , Marina Kunin A , Sarah Gafforini A and Gary L. Freed A C
+ Author Affiliations
- Author Affiliations

A Health Systems and Workforce Unit, The Centre for Health Policy, School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Parkville, Vic. 3010, Australia.

B Present address: National Human Genome Research Institute, Building 31, Room B1B54, 31 Center Drive, Bethesda, MD 20892-2073, USA.

C Corresponding author. Email: gary.freed@unimelb.edu.au

Australian Journal of Primary Health 23(3) 284-287 https://doi.org/10.1071/PY16094
Submitted: 5 August 2016  Accepted: 7 October 2016   Published: 30 November 2016

Abstract

The aim of this study was to identify motivators and barriers that paediatricians face when discharging patients from outpatient specialty care. A questionnaire was administered to outpatient care paediatricians in Victoria working in one of five speciality public hospital clinics. Questions focused on how important various motivators and barriers were in respondents’ decision to discharge a patient from their clinic. Nearly all (91%, n = 74) paediatricians invited to participate provided responses. The factor influencing the greatest proportion of paediatricians in their decision to discharge patients back to primary care was the potential that patients may not receive the required care from a GP. The next most highly rated barrier was that it is too complicated to arrange discharge; rated as a very important influence by one-third of paediatricians (33%, n = 24). Improvements to the discharge process may encourage more paediatricians to discharge patients back to their GP, therefore freeing up appointment slots. This in turn could reduce waiting times for paediatric outpatient clinics in Victoria. The concern from paediatricians that patients may not receive the required care from a GP warrants attention and should be further investigated.

Additional keywords: child health services, hospital outpatient clinics, patient discharge, referral and consultation.


References

American Academy of Paediatrics (2002) The medical home. Pediatrics 110, 184–186.
The medical home.Crossref | GoogleScholarGoogle Scholar |

Burkey Y, Black M, Reeve H, Roland M (1997) Long-term follow-up in outpatient clinics. 2. The view from the specialist clinic. Family Practice 14, 29–33.
Long-term follow-up in outpatient clinics. 2. The view from the specialist clinic.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s3hsV2ktA%3D%3D&md5=ae043dac6a566daf7abb94fc0a90b9bbCAS |

Department of Health and Human Services Victoria Australia (2010) Victorian public hospital specialist clinics: discharge guidelines. Available at https://www2.health.vic.gov.au/Api/downloadmedia/%7B8F65DC06-ADAB-4331-9E8A-E8F8F0814788%7D [Verified 15 October 2016]

Department of Health and Human Services Victoria Australia (2013) Specialist clinics service improvement guide. Available at https://www2.health.vic.gov.au/Api/downloadmedia/%7B8946077D-7254-493F-B5C7-7886DD5ACE16%7D [Verified July 15 October 2016]

Dodd KL, Rhead S, Towey K (1994) Paediatric medical outpatients: are all those reviews necessary? Archives of Disease in Childhood 70, 493–495.
Paediatric medical outpatients: are all those reviews necessary?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2czisVyhsQ%3D%3D&md5=e1c83960dfc8c83186f7cd2b7e5ef1e0CAS |

Freed GL, Spike NA, Sewell JR, Moran LM, Britt H, Valenti L, Brooks P (2013) Changes in longer consultations for children in general practice. Journal of Paediatrics and Child Health 49, 325–329.
Changes in longer consultations for children in general practice.Crossref | GoogleScholarGoogle Scholar |

Freed GL, Turbitt E, Kunin M, Gafforini S, Sanci L, Spike NA (2016) General practitioner perspectives on referrals to paediatric public specialty clinics. Australian Family Physician 45, 747–753.

Hughes ML, Leslie SJ, McInnes GK, McCormac K, Peden NR (2003) Can we see more outpatients without more doctors? Journal of the Royal Society of Medicine 96, 333–337.
Can we see more outpatients without more doctors?Crossref | GoogleScholarGoogle Scholar |

Kunin M, Turbitt E, Gafforini S, Sanci L, Spike N, Freed G (2016) Parental preferences for paediatric specialty follow-up care. Australian Health Review
Parental preferences for paediatric specialty follow-up care.Crossref | GoogleScholarGoogle Scholar | in press.

National Health and Hospitals Reform Commission (2009) A healthier future for all Australians: final report June 2009. Available at http://www.health.gov.au/internet/nhhrc/publishing.nsf/Content/nhhrc-report [Verified July 2016]

Turbitt E, Kunin M, Gafforini S, Sanci L, Spike NA, Freed GL (2016) Perspectives of Australian general practitioners on shared care for paediatric patients. Australian Journal of Primary Health
Perspectives of Australian general practitioners on shared care for paediatric patients.Crossref | GoogleScholarGoogle Scholar | in press.

Department of Health and Human Services Victoria Australia (2009) Victorian public hospital specialist clinics: strategic framework. Available at https://www2.health.vic.gov.au/Api/downloadmedia/%7B4CC7D85B-9488-498F-8A8D-AC650FC9DB4B%7D [Verified 15 October 2016]